Granulomatous skin disorders are a heterogeneous group of disorders characterized by granuloma formation on histopathology. They may be triggered by various stimuli, including infectious and non-infectious stimuli (foreign bodies, malignancy, metabolites, and chemicals), of different etiological origins. Although pathophysiological mechanisms are still poorly understood, infectious granuloma formation may occur if the patient’s immune system could not eliminate an agent. Clinically, localized or disseminated infectious granuloma formation can be related to the infectious agent’s pathogenicity or the patient’s immunity. Typical infectious agents causing infectious granulomatous reactions are mycobacteria, fungal infections, or parasites, such as leishmaniasis. This review aims to summarize granulomatous skin diseases encountered more frequently in our clinical experience because of infectious causes.

Background and Design: To investigate the contribution of informative presentations about acne vulgaris and questionnaires administered before and after informative meetings on patients’ awareness and consciousness.
Materials and Methods: Participants were asked to fill out a 20-question survey before and after informative seminars in hospitals and secondary and high schools as part of National Acne Week. The level of statistical significance was set as p≤0.05.
Results: A total of 466 participants completed the survey before and after the seminar, and the mean age of the participants was 17.4±6.9. Before the seminar, 31.1% of participants thought that acne is originated from the liver, whereas this figure decreased to 16.7% after the seminar. In all, 47.6% of participants consulted doctors and 23.9% consulted social media to seek information about acne; however, after receiving training, 77% preferred to consult a doctor. Of the participants, 51.1% were expecting to see the results of acne treatment in 1 or 2 weeks, whereas 83.3% stated that the effects would be seen in 2 or 3 months after the seminar. When the participants’ educational background was grouped as “secondary-high school-other,” a statistically significant difference was obtained (p<0.05).
Conclusion: Our study features both patients’ misconceptions and their incorrect attitudes about acne, and their level of knowledge improved significantly as a result of educational seminars. The relative benefit derived from educational seminars was positively related to the participants’ highest level of education.

Background and Design: This study aimed to compare neutrophil-lymphocyte ratio (NLR), carotid intima-media thickness (CIMT), epicardial fat tissue (EFT), and arterial stiffness values of psoriatic patients with healthy subjects and to determine the relation of these parameters with the severity of psoriasis.
Materials and Methods: This study included 102 patients with psoriasis and 102 control subjects matched according to age and gender. CIMT, echocardiographic EFT, arterial stiffness [aortic stiffness index (ASI) and aortic distensibility], anthropometric measurements, psoriasis area and severity index (PASI) score, and metabolic parameters were measured in all patients.
Results: The mean NLR in the psoriasis group were significantly higher than in the healthy group (2.3±0.74 vs 1.49±0.36; p<0.01). Additionally, CIMT (0.95±0.25 vs 0.57±0.13 mm; p<0.01), EFT (0.77±0.23 vs 0.42±0.12 cm; p<0.01), and ASI (3.21±0.37 vs 2.55±0.28; p<0.01) were significantly increased in patients with psoriasis than control subjects. Also, NLR was shown to be higher among psoriatic patients with PASI of ≥10. NLR was not correlated with CIMT, EFT, and ASI in psoriatic patients. Among psoriatic patients, ASI and EFT were positively correlated with age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, and uric acid, whereas CIMT was positively correlated with age and waist circumference (p<0.05 for all comparisons).
Conclusion: We found that psoriatic patients had higher atherosclerotic burden than healthy subjects and NLR had a stronger relation with the severity of psoriasis.

Background and Design: Type 1 diabetes mellitus (T1DM) can cause significant changes in the skin. However, there are limited studies examining the skin findings in children with T1DM. The objective of this study is to determine the frequency of skin lesions in children with T1DM. Additionally, this study also evaluates the relationship of skin lesions with disease duration and hemoglobin A1c (HbA1c) levels.
Materials and Methods: This cross-sectional study enrolled 65 children with T1DM and 78 age- and sex-matched healthy children. Importantly, detailed skin examinations of the cases were conducted. Results: The mean age at the onset of disease was 7.1±3.7 years, and the mean duration of T1DM was 45.9±40.4 months. The mean level of HbA1c in children with T1DM was determined as 8.0±1.6%. In total, 9 (13.8%) of the patients were using insulin infusion pump, whereas 56 of them were using multiple insulin injections therapy. At least one skin lesion related to insulin treatment was recorded in 54 patients (83%). Bruises (50.8%), lipohypertrophy (44.6%), and post-inflammatory hyperpigmentation (26.2%) were among the most observed skin reactions related to the insulin treatment. However, hypopigmented scar was the most frequently observed skin reaction related to the insulin treatment among the patients using insulin infusion pump (5/9, 55%). Only xerosis and rubeosis faciei diabeticorum were found to be significantly higher in the T1DM group, as compared to healthy controls. Xerosis was observed in 19 (29%) patients with DM and 8 (10.2%) healthy controls, whereas rubeosis faciei was observed in 6 (9.2%) patients with DM and 1 (1.3%) healthy control. Although not statistically significant, it was found that the disease duration was longer and HbA1c levels were higher in T1DM patients with rubeosis faciei or xerosis.
Conclusion: We believe that significant benefits can be provided for the management and prevention of skin findings in children with T1DM through the training of the patients and caregivers as well as by increasing the awareness of physicians.

Background and Design: Melanoma is a serious type of cancer. Patients previously diagnosed with melanoma are at an increased risk of a second melanoma. Therefore, it is important to know and apply preventive measures. This study aimed to examine melanoma patients’ behaviors of sun protection and skin self-examination (SSE), knowledge on risk factors, and communication with their physicians about the disease.
Materials and Methods: A questionnaire-based cross-sectional study was conducted in 65 melanoma patients to assess knowledge of melanoma and sun protection and determine SSE attitudes and patient-physician communication.
Results: Sun exposure was a well-known melanoma risk factor (67.7%), but the knowledge level on other risk factors, especially regarding skin, hair, and eye color phenotypes, was low (between, 21.5% and 36.9%). Sunscreen use practice was insufficient (33.8%) and mostly inadequate. The most commonly reported reason for not using sunscreen was not having a habit of sunscreen use (83.7%). Compliance with other sun protection behaviors was variable. Half (50.8%) of the melanoma patients reported that they perform SSE. The most commonly reported reasons for not performing SSE was not knowing its necessity (71.8%). More than one-third (35%) of patients stated that they did not receive information about melanoma from their physicians. Almost all patients who received information from their physicians were informed verbally, and only 4% received written information.
Conclusion: Our study highlights the need for a comprehensive education for patients about all aspects of melanoma and strategies to improve patient-physician communication. Barriers to preventive behaviors in melanoma patients may be determined in more detail in larger future studies and the content of education may be planned accordingly.

Background and Design: This study aims to examine the characteristics of young Turkish academic dermatologists and identify the positive and negative aspects of being an academic dermatologist from their perspectives.
Materials and Methods: A cross-sectional, electronic questionnaire was mailed to dermatologists who work as an assistant professor or faculty member of dermatology in a university or training and research hospital in Turkey. The questions were prepared to evaluate views of young academic dermatologists on academic dermatology.
Results: A total of 37 assistant professors and faculty members of dermatology responded to the survey. The top three reasons for pursuing an academic career and the most satisfying and pleasing aspects of academic life were the opportunity to teach, do research, and deal with complex diseases. Compensation was the least frequently (5.4%) chosen reason to pursue an academic life. Insufficient time (70.3%) was stated to be the most challenging aspect of research activities. The most cited issues respondents stated that they needed support or education were data analysis (78.4%) and training abroad (67.6%).
Conclusion: To our knowledge, this is the first study to evaluate academic dermatology in Turkey. We believe that the present study results provide insight into academic dermatology and might help increase the awareness of the dermatology residents who pursue an academic career

Mal de Meleda (MDM), also called keratoderma palmoplantaris transgrediens, is a rare autosomal recessive palmoplantar keratoderma with an estimated prevalence of 1: 100,000. Genetic mutations affecting SLURP-1 play a role in MDM. It typically starts shortly after birth and is characterized by hyperkeratosis extending from the palmoplantar region to the dorsal surfaces that worsens with age. MDM can lead to severe functional limitations involving the hands and feet and psychosocial problems. The rarity of the condition can lead to misdiagnoses and unsuitable treatments, with MDM commonly mistaken for psoriasis due to the involvement of the elbows and knees. This report presents the case of a family affected by MDM who had a pathogenic variant previously not reported in Turkey, been followed up with the diagnosis of psoriasis for several years, and received a late diagnosis where systemic acitretin achieved satisfactory clinical improvement.

This report presents a case of pigmented fungiform papillae of the tongue (PFPT) in a 12-year-old girl. She had type 1 and 2 PFPT. Diffuse, patchy tongue pigmentation seen in our patient might be a racial pigmentation or a component of PFPT. We also discussed whether the associated dental pigmentation could be an incidental finding or chromogenic bacteria or previous oral iron treatment might have a role in PFPT.